Open AccessEffect of Atrioventricular Dyssynchrony on Impella Hemodynamics: Mechanism and Its Clinical Implications
Author(s) -
Raj Baljepally,
Hassan Tahir
Publication year - 2021
Publication title -
cardiology research
Language(s) - English
Resource type - Journals
eISSN - 1923-2837
pISSN - 1923-2829
DOI - 10.14740/cr1287
Subject(s) - impella , medicine , cardiology , hemodynamics , cardiogenic shock , atrioventricular block , shock (circulatory) , myocardial infarction
The physiologic importance of atrial systole and atrioventricular (AV) synchrony in maintaining cardiac performance is well established. However, the role of AV synchrony in maintaining adequate Impella output has not been fully evaluated. Despite the common belief that AV dyssynchrony does not affect Impella output, given that Impella is a continuous flow device, recent reports indicate that AV dyssynchrony can lead to low Impella output in patients with cardiogenic shock complicated by complete heart block. Temporary transvenous pacing without establishing AV synchrony may fail to improve Impella hemodynamics; therefore, understanding the mechanism of low Impella output in AV dyssynchrony and promptly restoring AV synchrony may improve Impella output in such cases and lead to better outcomes.